The present invention relates generally to systems and methods for analyzing and assessing a subject""s relationships with mood altering chemicals. This method is described as The Chemical Use/Misuse Continuum (CUMC) Diagnostic System.
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There has long been an interest in how to deal with people that have alcohol and/or other drug (AOD) use problems. Enmeshed in this dilemma has been the ongoing debate and theoretical evolution in the counseling and medical fields towards developing a working definition that captures the complex nature of substance abuse disorders. Controversy remains regarding chemical dependency""s disease status, its etiology and the nature of its development. It is clear that those who are afflicted with the disorder suffer varying degrees of misery, the effects of which are also shared by society. However, objective, consistent and quantifiable methods for properly approximating the severity of such substance misuse have not yet been developed and widely accepted.
In the early 1950s, the American Medical Association (AMA) recognized alcoholism as a disease. However, the medical establishment""s frustration with treating and even diagnosing the disorder has marked its historically troubled involvement in dealing with this universally acknowledged health problem. The human and financial costs to our society are overwhelming. There is also an alarming discrepancy between the size of the problem, i.e., the number of patients hospitalized for alcohol/other drug mediated physical complications, and the proportion of curriculum time allocated to addiction by the medical schools in the training of the average medical student.
The first Diagnostic and Statistical Manual (DSM-I) published in 1952, by the American Psychiatric Association (APA) defined alcoholism as an xe2x80x9caddictionxe2x80x9d to alcohol. The DSM-II, DSM-III, DSM-III-R, and the DSM-IV followed the DSM-I in 1968, 1980, 1987, and 1994, respectively. Each new version provided a more updated interpretation of the disorder by the medical establishment. Despite this evolution, the DSM-IV diagnostic criteria still reflects an unreasonable level of subjectivity, with numerous incidences of non-specific terminology.
The DSM manuals are often considered to be difficult to apply as a diagnostic model, with a high level of scientific confidence, other than to making the most general of ill defined separations between three categories of xe2x80x9cnon-problemxe2x80x9d, xe2x80x9cproblemxe2x80x9d (i.e., substance abuse disorder), and xe2x80x9caddictivexe2x80x9d (substance dependence disorder) user categories.
A variety of screening instruments have been developed to facilitate making the diagnoses of substance use disorders in AOD using subjects and patients. However, each by their inherent nature reflect certain biases. It has been postulated that utilizing multiple screening instruments can mitigate these biases to some degree. Therefore, this invention includes, but is not limited to, the results from a battery of the following screening instruments:
1. Michigan Alcohol Screening Test (MAST)
Melvin L. Selzer, M.D.
University of California, San Diego
6967 Paseo Laredo
La Joya, Calif. 92037
This MAST is a 24-item questionnaire designed to differentiate alcoholics from non-alcoholics.
2. Numerical Drinking Profile (NDP)
This instrument is a six-question addendum to the MAST. The final determination of the NDP score is affected by the MAST score result. Therefore, the MAST must be scored before the NDP score can be determined.
3. The Drug Abuse Screening Test (DAST)
Dr. David Timken
Alcohol and Drug Abuse Division
Colorado Department of Health
4210 E. 11th Avenue
Denver, Colo. 80220
This test was developed by Harvey A. Skinner, Ph.D. and was based on Selzer""s MAST. The DAST is a 20-item questionnaire designed to demonstrate whether a drug problem exists as well as to demonstrate severity in a linear fashion.
4. Mortimer-Filkins Questionnaire (MFT).
National Technical Information Service
U.S. Department of Commerce
5285 Port Royal Road
Springfield, Va. 22151
Specify: U.S. Dept. Of Transportation Pub. No. DOT-145-800, PB 209 959.
The Mortimer-Filkins Test For Identifying Problem-Drinking Drivers was co-created by Rudolph G. Mortimer, Ph.D. and Lyle D. Filkins and includes a 58-item questionnaire designed to differentiate problem from non-problem social drinkers. Designed to evaluate drinking-drivers referred by the courts, the questionnaire should be accompanied by the Mortimer-Filkins Interview component for maximum validity. The Mortimer-Filkins test was designed to be used along with other types of information relevant to making a diagnosis, such as blood alcohol concentration (BAC) at time of arrest, driving record, criminal history, and other data usually available in court proceedings.
5. The Substance Abuse Subtle Screening Inventory (SASSI)
The SASSI Institute
P.O. Box 5069
Bloomington, Ind. 47407
A 93-item questionnaire designed to distinguish between substance dependent and non-dependent people. It has been asserted that individuals are not likely to feel threatened by the questions, and persons who try to conceal their problems will have difficulty guessing how to answer.
Heretofore, each of the instruments designed to screen for the AOD disorder, i.e., methods created to identify the presence or absence of addictive disorders, have had their own idiosyncratic prejudices and methodological inadequacies that compromise their strengths. What has been needed in the field is a method that overcomes these inadequacies by applying the results of multiple validated screening instruments in addition to other significant informational indices, to the diagnostic process.
The present invention relates to a method of evaluating a subject""s relationship with mood altering chemicals. It involves several steps, including an a evaluation of a subject""s prior arrest record, if any, and assigning a weighted value thereto. Also, the invention includes an evaluation of the negative symptomatology related to the subject""s developed tolerance levels to mood altering chemicals, if any, and assigning a weighted numerical value thereto. In addition, the invention includes an evaluation of potential biogenetic predisposition factors, if any, and assigning a weighted numerical value thereto.
The method of the present invention also includes a step of evaluating the subject""s prior and current chemical use history and weighting any generated negative symptomatology related to the subject""s medical, psychological, social and spiritual profile towards assigning the final diagnostic assessment finding. A diagnostic assessment finding is assigned to the subject based on a quantification of all the foregoing weighted values.
Ultimately, the final diagnostic assessment assignment falls within the xe2x80x9cChemical Use/Misuse Continuum (CUMC) Diagnostic Systemxe2x80x9d as described herein, and the placement score is selected from within one of six levels that correspond to increasing risk to self or society.